Disseminating Breast Cancer Prevention to African American Women

描述(由申请人提供)：传播是研究过程中一个重要但被忽视的组成部分。目前，努力的重点是传播通过随机试验制定和评估的干预措施；然而，还需要建立机制将研究结果传播给普通公众。AHRQ使用结构化程序来准备对条件的比较有效审查(CER)。尽管这些评论是为消费者开发的，但它们的影响可能有限，特别是在来自种族和少数民族群体的个人中，因为传播方法对文化不敏感，内容也不针对特定人群。我们小组在为非裔美国妇女开发有针对性的乳腺癌信息和使用文化敏感的传播战略接触这一人群方面拥有相当多的经验。因此，为了响应RFA-HS-10-004：AHRQ比较有效性审查的创新适应和传播，我们建议应用这些专业知识来开发和评估一种以社区为基础的方法，向非裔美国女性传播关于乳腺癌预防的CER。拟议研究的具体目的是：(1)根据社会人口学特征、对医学研究的信念和临床变量，评估基于社区的方法在向非裔美国女性传播乳腺癌预防CER方面的接受情况；(2)评估关于乳腺癌预防的循证(E)和非循证(NE)内容对心理和行为结果的影响，这些结果包括：关于乳腺癌的知识和预防方案，与社会和医疗网络中的个人的沟通，以及对医学研究的不信任。我们还将确定我们的传播努力在多大程度上达到了在人口统计学上代表费城大都市区非裔美国妇女的样本。这项研究将分两个阶段进行，确定通过E和NE含量以及心理和行为结果的变化来调节这种关系的变量。在第一阶段，我们将使用定性方法调整现有的乳腺癌预防药物CER，以增加其与非裔美国女性的相关性。在第二阶段，我们将评估基于社区的传播论坛的接受情况，并比较E和NE内容在200名非裔美国妇女样本中对预防知识、交流和对医学研究的不信任的影响。 与公共卫生相关：尽管总体上有所改善，但与族裔和种族群体的妇女相比，非裔美国妇女的乳腺癌发病率和死亡率仍然偏高。缺乏对预防乳腺癌的行为和医学策略的认识，导致非裔美国女性的预后较差。我们的研究将开发和评估一种新的、以社区为基础的战略，向有较差预后风险的妇女传播有关乳腺癌预防选择的信息。

DESCRIPTION (provided by applicant): Dissemination is an important, but neglected component of the research process. Currently, efforts focus on disseminating interventions that have been developed and evaluated through randomized trials; however, mechanisms are also needed to disseminate the results from research to the lay public. The AHRQ uses a structured process to prepare comparative effective reviews (CER) of conditions. Although these reviews are developed for consumers, they are likely to have limited reach, especially among individuals from racial and ethnic minority groups, because the dissemination methods are not culturally sensitive and the content is not targeted to specific populations. Our group has considerable experience developing targeted information about breast cancer for African American women and using culturally sensitive dissemination strategies to reach this population. Therefore, in response to RFA-HS-10-004: Innovative Adaptation and Dissemination of AHRQ Comparative Effectiveness Reviews, we propose to apply this expertise to develop and evaluate a community-based approach for disseminating CERs about breast cancer prevention to African American women. The specific aims of the proposed research are: (1) to evaluate uptake of a community-based approach for disseminating CERs about breast cancer prevention to African American women based on sociodemographic characteristics, beliefs about medical research, and clinical variables and (2) to evaluate the impact of evidential (E) versus non-evidential (NE) content about breast cancer prevention on psychological and behavioral outcomes that include: knowledge about breast cancer and prevention options, communication with individuals in their social and medical network, and distrust of medical research. We will also determine the extent to which our dissemination efforts reach a sample that is demographically representative of African American women in the Philadelphia metropolitan area. This study will be implemented in two Phases and identify variables that mediate the relationship by E and NE content and changes in psychological and behavioral outcomes. In Phase I, we will use qualitative methods to adapt an existing CER on medications for breast cancer prevention to increase its relevancy for African American women. In Phase II, we will evaluate the uptake of a community-based dissemination forum and compare the effects of E and NE content on knowledge, communication about prevention, and distrust of medical research in a sample of 200 African American women. PUBLIC HEALTH RELEVANCE: Despite overall improvements, African American women continue to experience excess rates of morbidity and mortality from breast cancer compared to women from ethnic and racial groups. Lack of awareness about behavioral and medical strategies for breast cancer prevention contributes to poorer outcomes among African American women. Our research will develop and evaluate a novel, community-based strategy for disseminating information about breast cancer prevention options to women at risk for poorer outcomes.